Clinically Effective Commissioning

The CCGs in Sussex are working together through the STP to standardise the non-emergency treatments and procedures available to patients across the region.

The review, led by local GPs, hospital doctors and other specialists, and overseen by the STP Clinical Board, will ensure that services offered to patients meet the latest guidelines from national experts and deliver value for money for the NHS budget.

At present there can be differences in the criteria used by local GPs to determine when patients should be referred for tests and treatment. Some procedures, for example tonsil removal, are four times more likely to be carried out in some parts of the area than others.

This issue, often referred to as a “postcode lottery”, means that some patients are not receiving treatment when they should, purely because of where they live, while others are receiving NHS-funded procedures that offer little or no clinical benefit.

So far, the CCGs across Sussex have adopted 12 standardised polices, covering a range of tests and treatments including tonsillectomies, gallstones and trigger finger. Standardisation has meant minor changes to some CCG policies, or the introduction of policies where they did not exist before.

The CCGs are now looking at policies where there are more significant differences between existing policies. Patients and the public are being engaged in this process over the coming months.

While clinicians leading the review believe that standardising many of the criteria will be straightforward, they acknowledge that there will need to be some difficult discussions where the evidence of positive outcomes for a patient’s health and wellbeing and value for money is not clear-cut.

CCGs have a formal duty to involve and consult local people over any proposals that would involve significant changes to services they provide.

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